Baby and You

Nursery teacher helping one of her students during a physical education lesson.

Childhood obesity is on the increase and is, worryingly, showing no signs of slowing down. Paul Gately highlights the potential health related consequences of obesity and the importance of reducing childhood obesity by supporting healthier choices

One in three children are overweight or obese making it one of the most common health conditions in our children. The UK has one of Europe’s highest levels of childhood obesity. Levels of overweight and obesity vary across regions, especially with those living in major city areas like London and Manchester, those in more deprived areas and some ethnic groups being more at risk of unhealthy weight gain. Obesity is a major concern for parents and as a national public health problem.

The UK has one of Europe’s highest levels of childhood obesity

PROBLEMS WITH BEING OVERWEIGHT AS A CHILD

Some reports suggest the children of today may not outlive their parents. This is due to the health consequences of obesity which include increased risks of heart disease, type 2 diabetes and several forms of cancer. Although these issues are very important, in the eyes of children such consequences are a long way off. How they feel, how they get treated by others and how happy they are being much more important to them.

Unfortunately, children who are overweight are more likely to suffer from depression, anxiety, and low self-esteem. Not only can these factors be caused by weight gain, they can also cause weight gain too. These mental health problems may or may not be linked with other social issues like difficulty in making friends, learning and interacting with others and ability to build effective relationships throughout life. These can all have a long term negative impact on school results, employment success and even future earnings.

The combined effects of poor mental health and social skills means many overweight children are more vulnerable to teasing and bullying. Many suffer in silence, so it is important that parents are vigilant, offer support and involve school representatives as early as possible.

One in three children are over-weight or obese

CAUSES OF WEIGHT GAIN

Causes of weight gain vary and are complicated, but the heart of the issue is eating more calories than those used by being physical active. This knowledge, however, is not always terribly helpful in terms of tackling weight gain, as it is too simplistic and suggests that all people need to do is “control” their food intake and activity levels.

Other factors that influence food intake and lack of physical activity should be considered. For example, we know that children are less likely to eat healthier food or be more physically active if they are tired. Research shows that children who sleep less than 10 hours a night at 3 years old have a three times greater risk of being obese by the age of 5.

Environment plays a big role and children are more likely to be overweight if they live in big cities.  Road safety concerns, stranger danger and availability of food (fast food, supermarkets, convenience stores, coffee shops and corners shops) all influence food and activity behaviours.

There’s evidence that children who face trauma (forms of abuse, family breakdown, or bereavement) are at greater risk of unhealthy weight gain as are those that live in chaotic families (where parents may be facing mental health issues, stress or financial challenges).

Genetic factors have an influence too and many of the contributing factors are not in direct control of the child or the parent. On a positive note, there is lots that parents can do to overcome these issues.

Children who are overweight are more likely to suffer from depression, anxiety, and low self-esteem

NUTRITION GUIDELINES

Supporting children to eat three meals a day with one or two healthy snacks is needed. The Eatwell Guide provides a good visual aid for parents. Use this to plan what to buy, aim for a minimum of 5 portions a day of fruit or vegetables and offer water as the first drink of choice. Mindful eating behaviour should be encouraged, such as eating more slowly, using smaller plates and serving smaller portions (sometimes called “me sized” portions).

EAT TOGETHER AS A FAMILY

Eating as a family is social and a time for families to get together to share stories about their day.  Whilst some people see mealtimes as a mundane activity, for children they are critical for their development. It’s an opportunity for them to spend quality time with parents and obtain feedback and support in a safe way. Parents can also monitor what and how much food is eaten.

Mealtimes for many parents often feel like a battle ground, but they don’t have to be. Take time with your meal and make it a family experience. A key rule is that parents control what is served and how much and children control how much they eat. In many families, this rule has been turned on its head, with children putting in their meal time orders just like a restaurant and then parents encouraging the child to “eat up”, with practices like “no dessert until you have finished your meal.” The impact of these approaches are that children are being taught to lose control of their eating behaviours which is certainly not what we are looking for!

VALUE OF REGULAR PHYSICAL ACTIVITY

Physical activity for kids is important for a variety of reasons. Whilst it’s true it can burn calories, there are many other benefits. Physical activity is a great way to build friendships, confidence and develop a variety of important social skills. It has positive impacts on mental health, lowering depression and anxiety and increasing self-esteem. Physical activity builds resilience and adds some structure to the day whilst taking their mind off food.

Children’s negative experiences of previous activity attempts will be an obvious barrier but with a bit of persistence they will find things they enjoy and pursue.

SCREEN TIME

Sedentary behaviours like TV watching, using computer games, tablets, and phones are all implicated in weight gain so ideally, they should be limited.

Children report that they engage in activity to be with their friends, to learn new skills and have fun, so physical activity should never be forced but strongly encouraged.

WHEN DO YOU NEED THE HELP OF A HEALTH PROFESSIONAL?

It’s not always easy to know, but there are some pointers. Age is an important consideration. In primary schools, all children are measured at reception and year 6. Those children that are identified in the overweight category will be notified. There is debate about doing this, but it’s a very useful indicator with very few children identified overweight when they are not. Other factors that should influence this decision include:

• If they say they are being teased and bullied for their weight

• If they tell you they think they have a weight problem.

• A little more controversially, if your child’s ribs are not obvious then they are likely to be in the overweight range.

As well as contacting a health professional, talk to school too as there is lots they can do to help.

HOW CAN MUM AND DAD HELP?

The most important thing to appreciate is that helping shape the weight of your child is not easy and should be considered as a ‘marathon not a sprint’. You are trying to influence several factors that have developed over quite a few years, some of which are parental influences too.

A short term approach will end in frustration and is only likely to make matters worse. The key is to be patient and supportive and to take action to encourage healthier behaviours as early as possible.

References available upon request.

AUTHOR BIO
Paul Gately is Director of MoreLife and a Professor of Exercise and Obesity at Leeds Beckett University, and is also a visiting professor in the Department of Surgery and Cancer at Imperial College London. Paul is the Principle Investigator on Public Health England’s Whole Systems Approach to Obesity and he is the Co-director of the Centre for Applied Obesity Research. His primary research interest is childhood obesity treatment strategies but also the wider determinants of obesity.

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